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青少年维生素D缺乏症的患病率及其与使用高分辨率外周定量计算机断层扫描的骨参数的相关性。

Prevalence of vitamin D insufficiency among adolescents and its correlation with bone parameters using high-resolution peripheral quantitative computed tomography.

作者信息

Cheung T F, Cheuk K Y, Yu F W P, Hung V W Y, Ho C S, Zhu T Y, Ng B K W, Lee K M, Qin L, Ho S S Y, Wong G W K, Cheng J C Y, Lam T P

机构信息

Bone Quality and Health Centre, Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, General Office, 5/F LCW Clinical Sciences Building, Sha Tin, NT, Hong Kong, China.

Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China.

出版信息

Osteoporos Int. 2016 Aug;27(8):2477-88. doi: 10.1007/s00198-016-3552-4. Epub 2016 Mar 24.

Abstract

UNLABELLED

Vitamin D deficiency and insufficiency are highly prevalent among adolescents in Hong Kong, which is a sub-tropical city with ample sunshine. Vitamin D level is significantly correlated with key bone density and bone quality parameters. Further interventional studies are warranted to define the role of vitamin D supplementation for improvement of bone health among adolescents.

INTRODUCTION

The relationship between bone quality parameters and vitamin D (Vit-D) status remains undefined among adolescents. The aims of this study were to evaluate Vit-D status and its association with both bone density and bone quality parameters among adolescents.

METHODS

Three hundred thirty-three girls and 230 boys (12-16 years old) with normal health were recruited in summer and winter separately from local schools. Serum 25(OH) Vit-D level, bone density and quality parameters by Dual Energy X-ray Absorptiometry (DXA) and High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT), dietary calcium intake, and physical activity level were assessed.

RESULTS

Sixty-four point seven percent and 11.4 % of subjects were insufficient [25 ≤ 25(OH)Vit-D ≤ 50 nmol/L] and deficient [25(OH)Vit-D < 25 nmol/L] in Vit-D, respectively. The mean level of serum 25(OH)Vit-D in summer was significantly higher than that in winter (44.7 ± 13.6 and 35.9 ± 12.6 nmol/L, respectively) without obvious gender difference. In girls, areal bone mineral density (aBMD) and bone mineral content (BMC) of bilateral femoral necks, cortical area, cortical thickness, total volumetric bone mineral density (vBMD), and trabecular thickness were significantly correlated with 25(OH)Vit-D levels. In boys, aBMD of bilateral femoral necks, BMC of the dominant femoral neck, cortical area, cortical thickness, total vBMD, trabecular vBMD, BV/TV, and trabecular separation were significantly correlated with 25(OH)Vit-D levels.

CONCLUSION

Vit-D insufficiency was highly prevalent among adolescents in Hong Kong with significant correlation between Vit-D levels and key bone density and bone quality parameters being detected in this study. Given that this is a cross-sectional study and causality relationship cannot be inferred, further interventional studies investigating the role of Vit-D supplementation on improving bone health among adolescents are warranted.

摘要

未标注

维生素D缺乏和不足在香港青少年中极为普遍,香港是一个阳光充足的亚热带城市。维生素D水平与关键的骨密度和骨质量参数显著相关。有必要进行进一步的干预研究,以确定补充维生素D对改善青少年骨骼健康的作用。

引言

青少年的骨质量参数与维生素D(Vit-D)状态之间的关系尚不明确。本研究的目的是评估青少年的Vit-D状态及其与骨密度和骨质量参数的关联。

方法

分别在夏季和冬季从当地学校招募了333名女孩和230名男孩(12 - 16岁),身体健康。评估血清25(OH)Vit-D水平、通过双能X线吸收法(DXA)和高分辨率外周定量计算机断层扫描(HR-pQCT)测量的骨密度和质量参数、膳食钙摄入量以及身体活动水平。

结果

分别有64.7%和11.4%的受试者Vit-D不足[25≤25(OH)Vit-D≤50 nmol/L]和缺乏[25(OH)Vit-D<25 nmol/L]。夏季血清25(OH)Vit-D的平均水平显著高于冬季(分别为44.7±13.6和35.9±12.6 nmol/L),且无明显性别差异。在女孩中,双侧股骨颈的面积骨密度(aBMD)、骨矿物质含量(BMC)、皮质面积、皮质厚度、总体积骨密度(vBMD)和小梁厚度与25(OH)Vit-D水平显著相关。在男孩中,双侧股骨颈的aBMD、优势股骨颈的BMC、皮质面积、皮质厚度、总vBMD、小梁vBMD、骨体积分数(BV/TV)和小梁间距与25(OH)Vit-D水平显著相关。

结论

维生素D不足在香港青少年中极为普遍,本研究发现维生素D水平与关键的骨密度和骨质量参数之间存在显著相关性。鉴于这是一项横断面研究,无法推断因果关系,因此有必要进行进一步的干预研究,以探讨补充维生素D对改善青少年骨骼健康的作用。

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